Agenda item

The presentation at the meeting will provide detail on the Buckinghamshire Framework for place based recovery from Covid-19, the 3 R’s to Recovery (Reset, Resilience and Restoration) led by the Member Recovery Board and the Buckinghamshire Recovery and Restoration Health and Care Plans led by the Integrated Care Partnership.

Lead presenters: David Williams and Rodger Goodes (on behalf of Sarah Ashmead). The presentation will also include updates from the key leads from the NHS, Adult Social Care, Public Health and Children’s Services to outline how each organisation has managed in response to the pandemic and the key priorities for stepping up services, recovery and reset.

·       Recommendation: The Health and Wellbeing Board is asked to note and discuss the information covered in the presentation on the 7 July and consider the role the Health and Wellbeing Board should play in the next phase of Buckinghamshire’s recovery and response.

Roger Goodes, Service Director, Policy and Communications, presented slides 24-27 on behalf of Sarah Ashmead, Deputy Chief Executive.  R Goodes highlighted the following points:

• The overarching approach to recovery across Buckinghamshire would be  focused on the following:

• A Member Recovery Board would lead the work aligned to existing partnerships through which the following partnerships would play a leading role:

David Williams, Director of Strategy, (BHT), and David Williams, Deputy Director of Quality (NHS), Buckinghamshire Clinical Commissioning Group presented slides 28-38, and highlighted the following points:

• The recovery model focussed on working in partnership as a health and social care system on behalf of the communities and patients.
• There were two over-arching groups; the Health Protection Board and the Clinical Harms Board.
• The recovery process would be long and complex and the way in which care would be delivered had changed; the Service would need to provide a flexible approach for patients to access care.
• Work had been undertaken to understand the potential clinical harm due to patients not having accessed care during the Covid-19 pandemic.
• The Buckinghamshire Clinical Harms Steering Group had been established to identify what could be carried out to mitigate the risk.
• Plans were being developed in preparation for a spike in the number of Covid-19 cases.  It was a complex piece of work involving colleagues from Public Health and other partners; any learning would be shared.
• The primary care, acute and community recovery approach had commenced.
• Routine operations had re-started.
• Treatment of urgent and cancer patients had continued throughout the pandemic.
• Community hospitals were re-opening.
• Out-patient appointments were re-starting.
• Support was being provided to the care home sector.
• All staff would be tested regularly for Covid-19 and would also have an anti-gen test.
• Referrals had reduced dramatically but were now at 75% of expected level.
• A & E attendance was now at 90% of expected level.
• There was a national campaign to promote that the NHS was ‘here and open’.
• The backlog of cancer patients who needed an operation would be cleared by the end of August 2020.
• All patients on waiting list had been contacted, reviewed and prioritised.
• If a second wave occurred it was likely that other services would be able to continue.

The following points were raised and discussed by members of the HWB:

• It was noted that the rapid setting up of the Olympic Lodge, which had provided extra capacity, had been achieved due to the partnership work across the organisations.
• A huge amount of encouraging information had been presented to the Board and it was agreed that a summary sheet should be produced by the Communications Team for sharing with the public.

ACTION:  Katie McDonald/Kim Parfitt

Debbie Richards, Managing Director, Oxford Health NHS Trust, presented slides 39-42 and highlighted the following points:

• Oxford Health NHS Trust covered Buckinghamshire, Oxfordshire, Swindon, Wiltshire and NE Somerset.
• The Service had changed the way in which it worked and the key messages were:

• The Service was preparing for a surge during the recovery period; call numbers and A&E attendances were increasing each week.
• Preparations in some areas e.g. children and young people were being prioritised.
• The waiting lists for assessments were being cleared to ensure support was in place for when children returned to school.
• There had been an increase in the number of training posts and people available to provide assessment and therapy due to additional investment that was agreed before Covid-19.  Recruitment had taken place during the pandemic.

The following points were raised and discussed by members of the HWB:

• The help line telephone numbers were provided; Adults - 0800 783 0119, Children - 0800 783 0121.
• In response to whether the reduction in numbers for older people was due to an access problem, D Richards explained that there were several reasons.  Some people were in residential settings and remote assistance was being provided to carers.  Some people were having support from their families.  There had also been suppressed demand because people were worried about coming forward during the pandemic.  Young people had embraced the move to a more digital service but it had proved more of a challenge for older people.

Gill Quinton, Corporate Director for Adults, Health and Housing, paid tribute to the phenomenal effort of her colleagues to ensure that vulnerable adults had remained safe during the pandemic.  G Quinton presented slides 43-51 and highlighted the following points:

• The Service had responded by setting up a number of separate cells covering the various areas.  Meetings were held every day, chaired by G Quinton, to ensure there was a co-ordinated approach across the county.
• All the adult social care services were maintained throughout crisis; the government did introduce some legislation that enabled local authorities to stand down some of the statutory requirements but Buckinghamshire Council did not invoke any of the legislation.
• Approximately 1200 vulnerable clients were supported by regular telephone calls to check their carers had arrived, that they had food and were receiving their medical supplies.  The calls were made by volunteers and staff; it had been extremely successful and would be continued by Prevention Matters. 
• The Day Care and short breaks services were closed but contact was maintained with the vulnerable clients.  The staff were redeployed and plans were being undertaken to re-open the services safely.
• The Olympic Lodge was transformed within three weeks to become a Reablement and care centre in case of a major surge in hospital discharges.
• The Government put in a requirement to discharge people who were fit for discharge within two hours; this was achieved across the whole system to free up hospital beds.
• The Choice Policy that enabled patients to choose their residential care home, the Continuing Health Care process and financial assessments had been suspended.
• Buckinghamshire Council’s efforts to support care providers had been identified as good practice by the Local Government Association.
• The Workforce Cell had prioritised retraining staff to be able to work in a care home if needed.
• A large number of volunteers had come forward.  Many of the volunteers helped at the Olympic Lodge and others contacted vulnerable clients.
• The Service was now focussed on recovery and taking forward the ‘positives’ learned during the pandemic.

Mr Tolis Vouyioukas, Corporate Director, Children’s Services, thanked all the staff in Children’s Services and the Schools Services for their commitment, leadership and hard work.  T Vouyioukas presented slides 52-56 and highlighted the following points:

• Immediate action was taken to ensure that staff could work from home.
• The Service was in constant contact with the Department for Education (DfE) and Ofsted so both were sighted on action the Service was taking in response to Covd-19.
• There had been a decline in the number of face to face visits at the beginning of the lockdown period but the number was now on the increase due to the easing of the restrictions.
• The DfE’s statutory process did not change; the Service worked out a way to meet the children’s needs and keep the staff safe.
• Children of key workers and vulnerable children were provided places in school.
• The website was kept up to date; regular meetings were held with the various partnerships in the school sector to provide government advice.

RESOLVED: The Health and Wellbeing Board NOTED and DISCUSSED the information covered in the presentation on the 7 July 2020 and CONSIDERED the role the Health and Wellbeing Board should play in the next phase of Buckinghamshire’s recovery and response.